Multi-Casualty Incident (MCI) Response

Section 2 - EMERGENCY OPERATIONS

PURPOSE:

The City of Maitland Fire Rescue Department operates under the Incident Command System (ICS). The purpose of this Plan is to establish a framework for supporting the ICS by providing public information, safety, inter-agency coordination, and policy guidance. By means of this direct support, the Incident Commander (IC), and Unified Command (UC) can better coordinate and facilitate incident management, operations, the delivery of services, and the accomplishment of incident objectives.
This Plan will identify the primary and support agencies, and their roles and responsibilities in response to an MCI. Maitland Fire Rescue Department will utilize an ICS response structure. An MCI is defined as one that exceeds the capabilities of the first arriving response units. Some examples of MCI types may be:

• Active Shooter
• Chemical
• Explosive
• Biological
• Building Collapse
• Plane Crash
• Vehicle Accident
• Radiological/Nuclear Incident
• Infectious Disease

When Maitland Fire Rescue responds for an MCI, this Plan will address the following:

• Direction and control of the incident
• Alert and notification of appropriate agencies
• Pre-hospital response measures
• Local, state, and federal resource coordination (if scene dictates, EOC will be activated and coordinate these resource allocations).

PROCEDURE:

City government must be organized and responsive prior to, during and immediately following the occurrence of an event that would generate large numbers of casualties. This plan establishes a framework for mass casualty incident response and sets forth responsibilities for the Maitland Fire Department responders to such events.

As with any mass casualty event, all responding agencies will need to work within the guidelines established by their respective operating guides and coordinate all activities through the Maitland Fire Rescue Department or Orange County’s Emergency Operations Center, when activated. Whatever the nature of the disaster, the basic components confronting emergency response agencies will involve:

• Ensure Scene Safety
• Identifying the incident as a Mass Casualty Incident (MCI)
• Perform triage and designate Casualty Collection Points (CCP)
• Providing emergency medical treatment at the scene
• Transport to hospitals while providing life supportive and sustaining measures.

MASS CASUALTY INCIDENT LEVELS

Mass casualty incidents shall be classified and referred to as four (4) separate response levels The following table defines MCI levels based on number of Potential casualties, and it also provides guidance for possible actions for consideration by emergency management staff.

MCI Level	I	II	III	IV
Potential Casualties	5 - 9	10 - 20	21 - 100	+100
Notification to State Watch		Yes	YES	YES
Notification to Red Cross (if applicable)		YES	YES	YES
Activation of EOC			YES	YES

CONSIDERATIONS

Operational concepts unique to mass casualty responses, responsibilities and efforts necessary for successful management of any mass casualty event occurring within the City of Maitland. MCI events involve triage, treatment, transport and logistical support.

• Once an MCI has been declared, command must establish communication with area hospitals in efforts to identify patient count vs. hospital capabilities (efforts must be made to not overwhelm one particular hospital). This can be completed by command if incident is on a smaller scale, or by treatment group officer if a larger incident has occurred.

ASSUMPTIONS

This plan assumes that the assertions, directions and initiatives found herein are valid for the City of Maitland. That events producing mass casualty incidents may often times overwhelm initial responders. That the mass casualty incidents have the potential to generate mass fatalities. Maitland Fire Rescue Department will conduct emergency operations for MCI events in accordance with this policy, as well as County, State and applicable Federal requirements.

• Mass casualty/mass fatality incidents may be due to a rapidly unfolding incident such as a terrorist attack, aviation incident, or an incident with advanced warning such as a hurricane or pandemic. Depending upon the incident, the casualties/fatalities may be located within a small area or spread throughout the city.
• Maitland Fire Rescue Department will have insufficient personnel, equipment, and transport capability to handle a significant number of victims. Automatic and Mutual Aid Assistance from other public and private agencies, the State, and Federal government may be required to respond to an incident.
• If the number of fatalities exceeds 20 in one incident, a request for a partial or full activation of the EOC may be made.
  • The decision to activate the EOC (whether partial or full), will be determined by the Fire Chief/Deputy Chief (during business hours), or the On-Call Chief (after-hours).
  • The Fire Chief or the On-Call Chief will be notified of the incident by the IC or Dispatch.
    • If the EOC is activated for a Multi-Casualty Incident, it must be understood the EOC is operating in a support mode, not as Incident Command.
    • Incident / Unified / Area – Command should remain at or near where the incident occurred until such time Command deems the scene is under control.

OPERATIONS

Definition: An MCI incident is to be declared any time emergency responders within the City of Maitland encounter situations with more victims than the initial responders can handle or anytime there are more than six victims requiring medical attention. Assignment of responsibilities: The first arriving emergency unit(s) upon determining the event to be an MCI event, shall declare such by radio and immediately initiate the Incident Command System ((ICS); see policy 110.01).